Systematic review with meta‐analysis: development of hepatocellular carcinoma in chronic hepatitis B patients with hepatitis B surface antigen seroclearance

Liu, F.; Wang, X.-W.; Chen, L.; Hu, Peng; Ren, Hong; Hu, Hailong

doi:10.1111/apt.13634

Cited by 75 publications

(84 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients chronically infected with hepatitis B virus (HBV), such seroclearance can occur after antiviral therapy, or, in 0.5%‐1% of patients per year, it can occur spontaneously . After HBsAg seroclearance, such patients may benefit from surveillance for hepatocellular carcinoma (HCC), as HBV can still be present at low replicative and transcriptional levels . In fact, HCC is the most frequent liver‐related complication after HBsAg seroclearance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Kuang

Jia

Huo

et al. 2018

Journal of Viral Hepatitis

View full text Add to dashboard Cite

There is no consensus about factors that increase risk of hepatocellular carcinoma (HCC) among patients with chronic hepatitis B who have achieved seroclearance of hepatitis B surface antigen (HBsAg). To assess the available evidence about risk factors for HCC after HBsAg seroclearance, Scopus, EMBASE, PubMed and Cochrane Library databases were systematically searched for relevant studies published through 15 September 2017. A total of 28 studies involving more than 105 411 patients with chronic hepatitis B were included. HBsAg seroclearance occurred spontaneously in 7656, while it occurred after interferon or nucleos(t)ide analogue therapy in 1248. The rate of HBsAg seroclearance was 6.77%. Incidence of HCC was significantly lower among patients who experienced HBsAg seroclearance than among those who remained HBsAg-positive (1.86% vs 6.56%, P < .001). Risk factors of HCC occurrence included cirrhosis (incidence with vs without: 9.51% vs 1.66%), male gender (2.34% vs 0.64%) and age ≥ 50 year at HBsAg seroclearance (2.34% vs 0.63%) (all P < .001). The available evidence suggests that HCC can develop at a low rate after HBsAg seroclearance, so periodic surveillance is recommended, especially for male patients, patients with cirrhosis and patients who experience HBsAg seroclearance when at least 50 years old.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Studies have already identified some patient characteristics that may be risk factors of HCC occurrence among patients who experience HBsAg seroclearance, such as cirrhosis, male gender and age ≥ 50 years . However, different studies disagree about some of these factors.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Kuang

Jia

Huo

et al. 2018

Journal of Viral Hepatitis

View full text Add to dashboard Cite

show abstract

“…There is less available data regarding the effect of the 3rd generation drugs, tenofovir and entecavir. One recent meta-analysis of patients with HBsAg seroclearance (n = 34,952) showed a significantly decreased risk for developing HCC in comparison to those with who did not seroconvert [risk ratio (RR) 0.34, 95% confidence interval (CI): 0.20-0.56, P < 0.001], but among those who seroconverted, 2.29% (95%CI: 1.19-4.37) still developed HCC [15] .…”

Section: Treatment Of Hbv and Hccmentioning

confidence: 99%

The impact of nucleos(t)ide analog therapy in hepatitis B on the incidence of hepatocellular carcinoma: an update including recent literature findings

Ayoub¹,

Dailey²,

Martin³

et al. 2017

View full text Add to dashboard Cite

How to cite this article: Ayoub WS, Dailey F, Martin P, Jones PD. The impact of nucleos(t)ide analog therapy in hepatitis B on the incidence of hepatocellular carcinoma: an update including recent literature findings. Hepatoma Res 2017;3:302-8.Worldwide, hepatocellular carcinoma (HCC) is a significant cause of morbidity and mortality. In men, it is the fifth most common cancer and seventh most common in women; HCC is the second highest cause of cancer-related death worldwide. It is less prevalent in the USA and Northern Europe and more prevalent in Eastern and South-Eastern Asia. Over 700,000 cases are diagnosed each year -half of which occur in China -and result in roughly the same number of deaths per year. HCC significantly impairs quality of life and is associated with great costs to society. It is estimated that half of the deaths from HCC are associated with hepatitis B virus (HBV). Fortunately, HBV vaccination and antiviral therapy have shown excellent efficacy in decreasing the incidence of HCC. We will discuss the relationship of HBV to HCC, address available treatments for HBV and the impact of treatment on the development of HCC. Key words:Liver cancer, hepatocellular carcinoma, hepatitis B, nucleos(t)ides, entecavir; tenofovir, lamivudine ABSTRACTArticle history:

show abstract

“…2 Liu et al conducted a meta-analysis of 28 smaller studies to overcome the limitations of insufficient statistical power common to studies evaluating the risk for HCC after HBsAg seroclearance. 3 Their results indicated that HBsAg seroclearance could be associated with a significant reduction in HCC risk; however, persons with HBsAg seroclearance were still at risk for HCC, especially those with established cirrhosis and aged >50 years. Jiang and colleagues presented an updated meta-analysis by eliminating duplicated studies from the analysis published by Liu et al 3 We commend their efforts, but we have two concerns with their alternative meta-analysis.…”

mentioning

confidence: 99%

“…3 Their results indicated that HBsAg seroclearance could be associated with a significant reduction in HCC risk; however, persons with HBsAg seroclearance were still at risk for HCC, especially those with established cirrhosis and aged >50 years. Jiang and colleagues presented an updated meta-analysis by eliminating duplicated studies from the analysis published by Liu et al 3 We commend their efforts, but we have two concerns with their alternative meta-analysis. First, Jiang and colleagues inferred the risk for HCC based on the pooled proportion of the participants who developed HCC across all of the studies.…”

mentioning

confidence: 99%

Letter: hepatocellular carcinoma risk after hepatitis B surface antigen seroclearance – authors’ reply

Gounder

Mosites

McMahon

2017

Aliment Pharmacol Ther

View full text Add to dashboard Cite

results of previous meta-analysis 4 that HBsAg seroclearance was significantly associated with a reduced risk for HCC development compared with those without HBsAg seroclearance (P < 0.001). In summary, existing lines of evidence indicate that spontaneous or post-treatment seroclearance of HBsAg, albeit rare, does occur in CHB patients. Moreover, such situation may not indicate viral clearance. HBV persisted at low replicative and transcriptional levels after HBsAg seroclearance. In order to provoke more and earlier HBsAg seroclearance in CHB patients, we need a better understanding of the mechanisms involved in HBsAg seroclearance.

show abstract

Systematic review with meta‐analysis: development of hepatocellular carcinoma in chronic hepatitis B patients with hepatitis B surface antigen seroclearance

Cited by 75 publications

References 53 publications

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

The impact of nucleos(t)ide analog therapy in hepatitis B on the incidence of hepatocellular carcinoma: an update including recent literature findings

Letter: hepatocellular carcinoma risk after hepatitis B surface antigen seroclearance – authors’ reply

Contact Info

Product

Resources

About